AB0999 Osteoarthritis. Pharmacoeconomics aspects of symptom-modifying therapy in real clinical practice.
Authors: I. Krysanov, V. Krysanova, V. Ermakova, N. Shostak, N. Pravdyuk
Journal: Annals of the Rheumatic Diseases (2022)

Background Treatment of osteoarthritis (OA) is a significant medical and social problem worldwide. Modern therapeutic approaches include a combination of pharmacological and non-pharmacological methods aimed at reducing pain, improving joint function, and preventing disease progression. A wide variety of symptomatic slow-acting drugs for osteoarthritis and their usage dictate the necessity for a clinical and economic analysis to select the most economically feasible treatment regimen for OA. Objectives To conduct a clinical and economic assessment of OA therapy using drugs of the SYSADOA group. Methods The search for publications for the period 2011-2022 on the clinical efficacy and safety of SYSADOA (bioactive concentrate of small marine fish containing chondroitin sulfate, amino acids, peptides, sodium, potassium, calcium, magnesium, iron, copper and zinc ions) was conducted using available sources (Medline, eLIBRARY.ru). The research selection methodology was in compliance with the PRISMA criteria(Preferred Reporting Items for Systematic reviews and Meta-analysis), 124 sources were analyzed. To collect data on the costs for managing patients in real clinical practice, a survey of 15 rheumatology experts was conducted with an assessment of the frequency and average duration of SYSADOA drugs usage. The direct medical costs paid from budgetary funds and/or funds of the compulsory medical insurance system related to the treatment of OA were assessed. Cost minimization analysis was carried out for 10 SYSADOA drugs; the average course cost of treatment was calculated according to the dosage regimens and duration of admission, as well as the cost of providing medical services. Results Analysis of the literature data showed that bioactive concentrate of small marine fish, produced by Biotehnos S.A. is a modern original SYSADOA for the initial therapy of knee joint OA with proven efficacy and safety. The estimated course cost of SYSADOA therapy ranges from 36.961 to 92 euros. The median exchange rate of all drugs in the sample was 50.2 euros; for SYSADOA drugs with oral administration - 85.82 euros; injectable drugs - 47.76 euros. The median amount of direct costs for injectable SYSADOA was 388,012 euros. Cost minimization analysis showed that the use of an alternating mode of administration of the drug (2 ml every other day intramuscularly - 10 injections) in patients with knee joint OA is the most cost-effective method for the treatment of OA and allows to reduce direct costs up to 64% per patient by reducing the number of medical services provided. Conclusion The analysis proved rationality of the established medical practice in prescribing of the injectable SYSADOA (bioactive concentrate of small marine fish was a leader among injectable SYSADOA according to HWC and IQVIA marketing analytical data for the period 2020-2021). Choosing the most economically feasible drug for the treatment of patients with OA will reduce the costs of the healthcare system and reduce the overall economic burden of OA. Disclosure of Interests None declared